Healthcare Provider Details

I. General information

NPI: 1245167360
Provider Name (Legal Business Name): MARIA GUADALUPE CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45465 25TH ST E SPC 263
LANCASTER CA
93535-1001
US

IV. Provider business mailing address

45465 25TH ST E SPC 263
LANCASTER CA
93535-1001
US

V. Phone/Fax

Practice location:
  • Phone: 661-209-7367
  • Fax:
Mailing address:
  • Phone: 661-209-7367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: